HER2 Support Group Forums - View Single Post - Is 0.1 margin clearance under tumor really Ok?

JessicaV · 01-12-2015, 06:39 AM

I had a 2.2cm IDC tumor in 6cm nuclear highgrade field DCIS. It was removed 1 year ago by mastectomy. The surgeon cut out an oval that went high above and low below the tumor to remove all the skin over the top of the tumor because it came relatively close to the surface.

My path results showed 0.1milimetres of clearance underneath it, ie chest wall.

That seems awfully close. Is it really a clear margin? Has anyone got any experience of such margins proving either fine or a problem?

I worry that it could have had micrometasases going through into the chest wall, that I may be at significantly at risk of chest wall recurrence. But I realise it could also be the thickness of a membrane that the tumor has not crossed over, a strong geographical boundary. Or not.

I have had no scans or xrays of that side of my chest since surgery or scheduled ahead. I would like to know how 0.1mm margins have worked out for others. Do you know of any true stories?
best wishes
Jessica

01-12-2015, 06:39 AM	#1
JessicaV Senior Member Join Date: Apr 2014 Posts: 206	Is 0.1 margin clearance under tumor really Ok? I had a 2.2cm IDC tumor in 6cm nuclear highgrade field DCIS. It was removed 1 year ago by mastectomy. The surgeon cut out an oval that went high above and low below the tumor to remove all the skin over the top of the tumor because it came relatively close to the surface. My path results showed 0.1milimetres of clearance underneath it, ie chest wall. That seems awfully close. Is it really a clear margin? Has anyone got any experience of such margins proving either fine or a problem? I worry that it could have had micrometasases going through into the chest wall, that I may be at significantly at risk of chest wall recurrence. But I realise it could also be the thickness of a membrane that the tumor has not crossed over, a strong geographical boundary. Or not. I have had no scans or xrays of that side of my chest since surgery or scheduled ahead. I would like to know how 0.1mm margins have worked out for others. Do you know of any true stories? best wishes Jessica __________________ 1997-2004 many cysts, many MG & U/S: polycystic breasts. Sept 2013 found lump,Cyst?? forgot lump. Dec 2013 GP check, Referred for U/S, MG,FNA. 7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail." Cancelled my psych clients for the week. 8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon. Cancelled my psych clients for the month. 13 Jan 14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan, 16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done. 19 Jan 14 discharged home with 1 drain. 22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment. 26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans. 30 Jan 14 HER2+ high amplification, 13 gene copies per cell. 21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up. Cancelled my psych clients for 6 months. Feb 14 First MUGA test: 71%, First C15.3 test: 20 7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and Claritin, reflux/indigestion helped by Somac. July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily. Sept 14 Second MUGA test: 69% Cancelled my psych clients for 2014 Dec 14 Third MUGA test: 70% Second C15.3 test : 20 Cognitive fatigue delays return to work. March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring. July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing Aug 2015 Heart good, no evidence of cancer, just Fatigue. May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets. Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.